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尼泊尔农村老年人中慢性非传染性疾病、多种疾病及其相关因素的流行情况:一项横断面研究。

Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study.

机构信息

Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia

Center for Research Policy and Implementation, Biratnagar, Nepal.

出版信息

BMJ Open. 2021 Feb 25;11(2):e041728. doi: 10.1136/bmjopen-2020-041728.

Abstract

OBJECTIVES

This study's objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors.

DESIGN

This was a community-based cross-sectional study conducted between January and April 2018.

SETTING

Rural municipalities of Sunsari and Morang districts in eastern Nepal.

PARTICIPANTS

794 older Nepalese adults, 60 years and older, were recruited using a multistage cluster sampling approach.

PRIMARY OUTCOME MEASURES

Prevalence of four major non-communicable chronic conditions (osteoarthritis, cardiovascular disease, diabetes and chronic obstructive pulmonary disease (COPD) and multimorbidity.

RESULTS

Almost half (48.9%: men 45.3%; women 52.4%) of the participants had at least one of four non-communicable chronic conditions, and 14.6% (men 12.5%; women 16.8%) had two or more conditions. The prevalence of individual conditions included: osteoarthritis-41.7% (men 37.5%; women 45.9%), cardiovascular disease-2.4% (men 2.8%; women 2.0%), diabetes-5.3% (men 6.0%; women 4.6%) and COPD-15.4% (men 13.3%; women 17.5%). In the adjusted model, older adults aged 70-79 years (adjusted OR (AOR): 1.62; 95% CI: 1.04 to 2.54), those from Madhesi and other ethnic groups (AOR: 1.08; 95% CI: 1.02 to 1.72), without a history of alcohol drinking (AOR: 1.53; 95% CI: 1.18 to 2.01) and those physically inactive (AOR: 5.02; 95% CI: 1.47 to 17.17) had significantly higher odds of multimorbidity.

CONCLUSIONS

This study found one in seven study participants had multimorbidity. The prevalence of multimorbidity and associated socioeconomic and behavioural correlates need to be addressed by integrating social programmes with health prevention and management at multiple levels. Moreover, a longitudinal study is suggested to understand the temporal relationship between lifestyle predictors and multimorbidity among older Nepalese adults.

摘要

目的

本研究旨在估计尼泊尔农村老年人中主要非传染性疾病和多种疾病的患病率,并探讨相关的社会经济和行为风险因素。

设计

这是一项于 2018 年 1 月至 4 月在尼泊尔东部桑萨里和莫朗地区的农村进行的基于社区的横断面研究。

地点

尼泊尔农村的桑萨里和莫朗地区。

参与者

采用多阶段聚类抽样方法,招募了 794 名年龄在 60 岁及以上的老年尼泊尔人。

主要结局指标

四种主要非传染性慢性疾病(骨关节炎、心血管疾病、糖尿病和慢性阻塞性肺疾病(COPD)和多种疾病的患病率。

结果

近一半(48.9%:男性 45.3%;女性 52.4%)的参与者至少有一种非传染性慢性疾病,14.6%(男性 12.5%;女性 16.8%)有两种或两种以上疾病。个别疾病的患病率包括:骨关节炎-41.7%(男性 37.5%;女性 45.9%)、心血管疾病-2.4%(男性 2.8%;女性 2.0%)、糖尿病-5.3%(男性 6.0%;女性 4.6%)和 COPD-15.4%(男性 13.3%;女性 17.5%)。在调整后的模型中,70-79 岁的老年人(调整后的比值比(AOR):1.62;95%可信区间:1.04 至 2.54)、来自马德西和其他族裔群体的成年人(AOR:1.08;95%可信区间:1.02 至 1.72)、没有饮酒史的成年人(AOR:1.53;95%可信区间:1.18 至 2.01)和不活跃的成年人(AOR:5.02;95%可信区间:1.47 至 17.17)发生多种疾病的可能性显著更高。

结论

本研究发现每 7 名参与者中就有 1 人患有多种疾病。需要通过在多个层面上整合社会方案与健康预防和管理,来解决多种疾病的患病率以及相关的社会经济和行为相关性问题。此外,建议进行一项纵向研究,以了解尼泊尔老年人口生活方式预测因素与多种疾病之间的时间关系。

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